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Dodgen L, Kitzman H, Spence E, Mamun A, Walters ST, Cervantes D. What's theory got to do with it: measuring effects of theory on lifestyle behaviors and weight in the Better Me Within Randomized Trial. AMERICAN JOURNAL OF HEALTH EDUCATION 2023; 54:86-98. [PMID: 37396565 PMCID: PMC10311983 DOI: 10.1080/19325037.2022.2163007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/08/2022] [Indexed: 02/19/2023]
Abstract
Background Knowing which theoretical constructs work best to design effective interventions is essential for populations with increased disease burden. African American women (AAW) experience greater prevalence of chronic diseases and fewer benefits from weight loss interventions compared to White women. Purpose To examine how theoretical constructs were associated with lifestyle behaviors and weight outcomes in the Better Me Within (BMW) Randomized Trial. Methods BMW used a tailored diabetes prevention program implemented in churches among AAW with BMI ≥ 25. Regression models assessed relationships between constructs (self-efficacy, social support and motivation), and outcomes (physical activity (PA), calories, and weight). Results Among 221 AAW (mean (SD) age 48.8 years (11.2); mean weight 215.1 pounds (50.5), several significant relationships were found including an association between change in motivation for activity and change in PA (p=.003), and change in motivation for diet and weight at follow-up (p=<.001). Discussion The clearest relationships emerged for PA with motivation for activity and weight management social support demonstrating significance in all models. Translation to Practice Self-efficacy, motivation and social support show promise to promote changes in PA and weight among church-going AAW. Opportunities to keep engaging AAW in research are essential for eliminating health inequities in this population.
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Affiliation(s)
- Leilani Dodgen
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
| | - Heather Kitzman
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
- Robbins Institute for Health Policy & Leadership, Baylor University, Waco, TX, USA
| | - Emily Spence
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Abdullah Mamun
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
- Ethicon, Raritan, NJ, USA
| | - Scott T. Walters
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Diana Cervantes
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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Kramer EB, Knight EL, Bryan AD. Cooking Interventions for Improving Diet Quality Among Black Americans: A Randomized Controlled Trial. Ann Behav Med 2023; 57:323-333. [PMID: 36734623 DOI: 10.1093/abm/kaac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Non-Hispanic Black Americans experience the highest, and most rapidly increasing, rates of obesity. Despite evidence that this is at least somewhat related to poor diet quality, we have yet to identify effective interventions for improving diet quality long-term. Restrictive diets can be ineffective and often harmful. In contrast, there is a well-established connection between home cooking and lower body mass index, better diet quality, and improved health. PURPOSE The present study applied the Theory of Planned Behavior (TPB) to examine the effect of an intervention delivering cooking instruction, rather than nutrition information, on beliefs, attitudes, and behaviors pertaining to diet quality and cooking among Black adults in the USA. METHODS An online sample of Black Americans (N = 147), ages 18-76 (M = 30.69, SD = 10.42) were recruited via Prolific and randomized to view either a cooking tutorial video or a "standard of care" control webpage followed by either an implementation intentions (II) writing activity or a "freestyle" control writing activity. Cognitions and behavior related to healthy eating and cooking were measured at baseline, post-intervention, and 1-week follow-up. RESULTS Results of mixed-effects modeling indicated that participants randomized to the video condition reported significantly greater post-intervention intentions to cook (p < .001), which positively correlated with cooking behavior over the subsequent week (p < .01). There was no effect of the II intervention on subsequent-week behavior (ps > .413). Importantly, 75% (n = 105) indicated experiencing food insecurity at the time of data collection. CONCLUSIONS These results highlight a promising pathway for improving nutrition and diet-related health outcomes among Black Americans while highlighting that any intervention must account for food insecurity in this population.
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Affiliation(s)
- Emily B Kramer
- Department of Psychology and Neuroscience, University of Colorado Boulder, 345 UCB, Boulder, CO 80309-0345, USA
| | - Erik L Knight
- Department of Psychology and Neuroscience, University of Colorado Boulder, 345 UCB, Boulder, CO 80309-0345, USA
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, 345 UCB, Boulder, CO 80309-0345, USA.,Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
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Boutté RL, Burnette CB, Mazzeo SE. BMI and Disordered Eating in Black College Women: The Potential Mediating Role of Body Appreciation and Moderating Role of Ethnic Identity. JOURNAL OF BLACK PSYCHOLOGY 2022; 48:604-630. [PMID: 36817849 PMCID: PMC9933245 DOI: 10.1177/00957984211069064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Multiple studies indicate Black American women have disproportionately higher rates of obesity compared with other groups in United States. Although body image is associated with obesity, this relation is understudied among Black women. The purpose of the current study was to (1) examine the relations among body appreciation, body dissatisfaction and disordered eating; (2) assess body appreciation as a mediator of the relation between body mass index (BMI) and disordered eating, and (3) explore ethnic identity as a moderator in this association. Participants were 191 Black women recruited from a mid-Atlantic university. Participants' mean age was 19.16 years (SD = 1.95). Body appreciation partially mediated the relation between BMI and disordered eating behaviors and attitudes, such that women with higher BMIs reported lower body appreciation, which was associated with greater disordered eating symptoms. Ethnic identity was not a significant moderator of the association between BMI and body appreciation. Results support screening Black women with higher BMIs for disordered eating symptomatology and suggest it might be helpful to include body appreciation in interventions for Black women.
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Affiliation(s)
- Rachel L. Boutté
- Department of Psychology, Richmond, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - C. Blair Burnette
- Department of Psychology, Richmond, Virginia Commonwealth University, Richmond, VA, USA,Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Suzanne E. Mazzeo
- Department of Psychology, Richmond, Virginia Commonwealth University, Richmond, VA, USA
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Zhu H, Ren Z, Hua H, Zhao K, Ding L, Zhu S, Yang N, Liang H, Xu Q. Development and Validation of a Questionnaire to Assess the Determinants of Dietary Adherence Among Patients After Bariatric Surgery. Patient Prefer Adherence 2021; 15:2865-2875. [PMID: 35002224 PMCID: PMC8722285 DOI: 10.2147/ppa.s344662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/10/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE This study was aimed to develop a questionnaire to assess the determinants of dietary adherence among patients after bariatric surgery based on the attitude-social influence-efficacy (ASE) model and to evaluate its psychometric properties. PATIENTS AND METHODS According to semi-structured interview, Delphi expert consultation and pilot study, the initial questionnaire was formed and applied to investigate 319 patients after bariatric surgery in a tertiary hospital in Jiangsu Province, China. The reliability and validity of the scale were tested. RESULTS The 28-item of the attitude-social influence-efficacy questionnaire after bariatric surgery (ASEQBS) was formed. The results of exploratory factor analysis showed that four factors, including intention, attitude, social influence, and self-efficacy, could be extracted, and the cumulative variance contribution rate reached 59.98%. Confirmatory factor analysis showed the model fit well. The content validity index of each item was 0.800-1.000, and the content validity index of the ASEQBS was 0.857. The total Cronbach's α of the ASEQBS was 0.920, the split-half reliability was 0.774, and the retest reliability was 0.922. CONCLUSION The results suggest that ASEQBS is a valid and reliable measure of determinants of dietary adherence. It may be useful to evaluate the influence factors of dietary adherence and helpful to evaluate the efficacy of tailored dietary intervention programs.
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Affiliation(s)
- Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Ziqi Ren
- School of Nursing, Fudan University, Shanghai, People’s Republic of China
| | - Hongxia Hua
- Department of Bariatric and Metabolic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Lingyu Ding
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Ningli Yang
- Department of Bariatric and Metabolic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Hui Liang
- Department of Bariatric and Metabolic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
- Correspondence: Qin Xu School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, Jiangsu, 210029, People’s Republic of ChinaTel +86-25-86869553; +86-13601587208Fax +86-25-86869555 Email
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Weight Management Interventions for Adults With Overweight or Obesity: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2020; 121:1855-1865. [PMID: 33069660 DOI: 10.1016/j.jand.2020.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/30/2020] [Accepted: 07/21/2020] [Indexed: 12/26/2022]
Abstract
The objectives of this evidence scoping review were to identify and characterize studies investigating weight management interventions provided by a registered dietitian nutritionist or international equivalent (RDN) among adults with overweight or obesity. A medical librarian conducted an electronic literature search in 6 databases-MEDLINE (Ovid), Embase (Ovid), PyscINFO (Ovid), Cochrane CENTRAL (Ovid), Cochrane Database of Systematic Reviews (Ovid), and CINAHL (Ebsco). Except for narrative review, gray literature, and case study or report, all types of peer-reviewed articles published between January 2008 and April 26, 2019 were eligible. Two content advisors, who are experts in adult weight management, guided the process and reviewed the search plan and findings. The literature search resulted in 30,551 records with 16 additional records identified through other sources. A total of 29,756 records were excluded during the first round of screening due to duplication or irrelevancy. Of the 811 full-text articles that were screened, 139 met the criteria and were included. Approximately 51% and 43% of the studies were conducted in the community setting and in the United States or Canada, respectively. Over 97% of the studies were clinical or quasi-experimental trials. A total of 6 different intervention delivery modes were reported, which resulted in 22 combinations of the modes of delivery. RDNs delivered the weight management intervention (especially the nutrition component) in all studies, but some (61%) also involved an interdisciplinary team to deliver other components of the intervention. The average length of the intervention was about 10 months with a follow-up that ranged from 0 to 9 years. The commonly reported outcomes were anthropometrics, endocrine, and cardiovascular measures; dietary intake; and physical activity. Based on the scoping review, there were systematic reviews and evidence-based practice guidelines on weight management interventions but none of them met the a priori inclusion or exclusion criteria. Therefore, it would be beneficial to conduct a systematic review and develop an evidence-based practice guideline on adult weight management interventions provided by an RDN to guide practitioners and to evaluate their effects on health and nutrition-related outcomes.
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Abstract
Effective health promotion among African American women requires knowledge and understanding of cultural influences and practices. This scoping review focused on rest, related concepts, and cultural perspectives and practices. We found a lack of conceptual distinction between fatigue and sleep and limited research on cultural meanings and practices of rest.
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